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Lookup NU author(s): Professor Stephen BourkeORCiD,
Dr Simon Doe,
Dr Carlos EchevarriaORCiD
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© 2022 European Cystic Fibrosis Society. The authors regret an error has occurred in the description and calculation of dose-weighted composite MPR (dwcMPR) for participants on multiple medicines. We described dose-weighting according to the number of dispensed inhaled medications. In fact, the dose-weighting should be based on the number of prescribed inhaled medications to ensure there is no gap between the cMPR and electronic data capture (EDC) adherence if someone has indeed used all the medicines that were supplied. Therefore, the first step to calculate dwcMPR should have been: calculate the total prescribed doses of medicine by adding up of all individual values of daily prescribed dose × days. We have now re-calculated the relevant values for the difference between dwcMPR and unadjusted EDC adherence, and the cost of excess supply using this method. We have also repeated the relevant analyses. A summary of the updated results are as follow: 1. Table 1 (demographics) – Median % dwcMPR 67 (IQR 39 to 91)2. Figure 1 Bland-Altman plot of dwcMPR versus EDC adherence) – Mean difference 10% (limits of agreement -38% to 59%). An updated Figure 1 is attached.3. Table 2 (dwcMPR versus EDC adherence discrepancy and excess supply cost) – Discrepancy median 9% (IQR -2% to 21%). Mean excess supply cost for overall cohort £822 (95% CI £587 to £1057). The total excess supply cost was £226,104 among the 275 adults. An updated Table 2 is attached.4. Table 3 (results from linear regression models) – With excess supply cost in £ as the outcome, the unadjusted regression coefficient for unadjusted EDC adherence was -739 (95% CI -986 to -491) and the adjusted regression coefficient was -660 (95% CI -908 to -410). Similar to the initial analyses, excess supply cost was higher among those with EDC adherence <50%, aged 19-25 years and on inhaled antibiotics rather than mucolytics only. An updated Table 3 is attached.5. Figure 2 (tree-based analysis) – Similar to the initial analyses, excess supply cost was higher among those with EDC adherence <50%, aged 19-25 years and on inhaled antibiotics rather than mucolytics only. An updated Figure 2 is attached.6. Appendix A (participants with skewed MPR data) – the details for skewed MPR data and the values of dwcMPR, ‘standard’ composite MPR (i.e. a mean of all individual MPR) and unadjusted EDC adherence are now tabulated in Table S3 (attached). Where MPR data were skewed, EDC adherence is more similar to dwcMPR compared to ‘standard’ cMPR.In Appendix C, we calculated the minimum excess supply cost based on the assumption that more expensive medications were used first and maximum excess supply cost based on the assumption that cheaper medications were used first. The minimum and maximum excess supply costs were calculated directly from the total doses of supplied medications without the need to calculate a composite MPR. Therefore, the results in Appendix C are unaffected. Overall, the reduction in excess supply cost (mean £822, 95% CI £587-1057 with the revised method vs mean £1124, 95% CI £855-1394 with the method as originally described) does not alter the conclusions of the paper. MPR provides information about medicine supply but over-estimates actual medicine use. The excess supply cost was highest among those with lowest EDC adherence. Our study provides a conservative estimate of excess inhaled medicines supply cost among adults with CF in the UK. Importantly, the lowest excess supply cost of £1,325/patient/year among those with EDC adherence <50%, suggests there are potential annual savings of around £2.5 million. The authors would like to apologise for any inconvenience caused.
Author(s): Bevan A, Hoo ZH, Totton N, Girling C, Davids IR, Whelan P, Antrobus S, Ainsworth J, Buchan I, Anderson A, Bourke S, Doe S, Echevarria C, Taylor J, Bell NJ, Bateman K, Jones C, Moran P, Fitch G, Martin M, McGowan A, Morrow S, Seabridge H, Bush N, Daniels T, Lee K, Robson N, Shiferaw D, Sweis D, Thomas R, Faulkner J, Flight WG, Poole S, Warnock L, Allenby MI, Carroll M, Daniels TV, Dunn H, Nightingale JA, Shepherd E, Ohri C, Gadsby J, Range S, Tature D, Barr HL, Dawson S, Dewar J, Miller B, Saini G, Galey P, Johnson J, Pasteur MC, Derry D, Gledhill H, Lawson A, Thomas M, Waine D, Cunningham J, Damani A, Higton A, Orchard C, Carolan C, Tahir M, Plummer A, Hutchings M, Edenborough FP, Curley R, Wildman MJ
Publication type: Note
Publication status: Published
Journal: Journal of Cystic Fibrosis
Pages: Epub ahead of print
Online publication date: 28/07/2022
Acceptance date: 02/04/2018
ISSN (print): 1569-1993
ISSN (electronic): 1873-5010
Publisher: Elsevier B.V.